Dangerous bacteria in unexpected locations; Burkholderia pseudomallei and melioidosis in Australia

SUMMARYMelioidosis is an infectious disease caused byBurkholderia pseudomallei, a bacterium endemic in Southeast Asia and northern Australia. In New Caledonia, sporadic cases were first described in 2005; since then, more cases have been identified. To improve our understanding of melioidosis epidemiology in New Caledonia, we compared the local cases andB. pseudomalleiisolates with those from endemic areas. Nineteen melioidosis cases have been diagnosed in New Caledonia since 1999, mostly severe and with frequent bacteraemia, leading to three (16%) fatalities. All but one occurred in the North Province. Besides sporadic cases caused by non-clonal strains, we also identified a hotspot of transmission related to a clonal group ofB. pseudomalleithat is phylogenetically related to Australian strains.

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Outcomes of Patients with Melioidosis Treated with Meropenem

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.48.5.1763-1765.2004 ◽

2004 ◽

Vol 48 (5) ◽

pp. 1763-1765 ◽

Cited By ~ 52

Author(s):

Allen C. Cheng ◽

Dale A. Fisher ◽

Nicholas M. Anstey ◽

Dianne P. Stephens ◽

Susan P. Jacups ◽

...

Keyword(s):

Severe Sepsis ◽

Southeast Asia ◽

Selection Bias ◽

Burkholderia Pseudomallei ◽

Northern Australia ◽

Drug Fever ◽

Improved Outcomes

ABSTRACT Melioidosis, an infection due to Burkholderia pseudomallei, is endemic in southeast Asia and northern Australia. We reviewed our experience with meropenem in the treatment of severe melioidosis in 63 patients over a 6-year period. Outcomes were similar to those of ceftazidime-treated patients (n = 153) despite a deliberate selection bias to more-unwell patients receiving meropenem. The mortality among meropenem-treated patients was 19%. One patient had a possible drug fever associated with the use of meropenem. We conclude that meropenem (1 g or 25 mg/kg every 8 h intravenously for ≥14 days) is an alternative to ceftazidime and imipenem in the treatment of melioidosis. The use of meropenem may be associated with improved outcomes in patients with severe sepsis associated with melioidosis.

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Burkholderia pseudomalleiInfection in a Cystic Fibrosis Patient from the Caribbean: A Case Report

Canadian Respiratory Journal ◽

10.1155/2008/290412 ◽

2008 ◽

Vol 15 (5) ◽

pp. 237-239 ◽

Cited By ~ 13

Author(s):

Dimas Mateos Corral ◽

Allan L Coates ◽

Yvonne CW Yau ◽

Raymond Tellier ◽

Mindy Glass ◽

...

Keyword(s):

Cystic Fibrosis ◽

Case Report ◽

Southeast Asia ◽

Cystic Fibrosis Patient ◽

North American ◽

Burkholderia Pseudomallei ◽

Northern Australia ◽

The Caribbean ◽

Endemic Areas

Burkholderia pseudomalleiis a pathogen identified with increasing frequency in the respiratory tracts of cystic fibrosis (CF) patients from endemic areas such as Southeast Asia and northern Australia. The following report describes the first known reported case in a CF patient from the Caribbean attending a North American CF clinic.

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Infected aneurysm after returning from Southeast Asia: think Burkholderia pseudomallei!

BMJ Case Reports ◽

10.1136/bcr-2018-228856 ◽

2019 ◽

Vol 12 (5) ◽

pp. e228856 ◽

Cited By ~ 1

Author(s):

Clément Auvens ◽

Catherine Neuwirth ◽

Lionel Piroth ◽

Mathieu Blot

Keyword(s):

Southeast Asia ◽

Burkholderia Pseudomallei ◽

Endemic Area ◽

Clinical Manifestations ◽

Psoas Muscle ◽

Northern Australia ◽

Infected Aneurysm ◽

Microbiological Methods ◽

Unexplained Fever ◽

Infected Aortic Aneurysm

Melioidosis is a protean disease which is endemic to Southeast Asia and northern Australia. Here, we report a case of infected aortic aneurysm due to Burkholderia pseudomallei in an immunocompetent man 6 months after a trip to northern Malaysia. This patient initially received inappropriate surgical and antibiotic treatment, leading to a peri-prosthetic aortic infection with lumbar spondylitis and contiguous psoas muscle abscess. This case highlights the difficulty of diagnosing melioidosis given its diverse clinical manifestations and the limits of routine microbiological methods to identify B. pseudomallei. Melioidosis should be considered a possible diagnosis in individuals with unexplained fever subsequent to travel in an endemic area.

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ACTUAL ISSUES OF MODERN EPIDEMIOLOGY OF MELIOIDOSIS: A LITERATURE REVIEW AND ANALYSIS OF IMPORTED CASES TO NON-ENDEMIC REGIONS

Epidemiology and Infectious Diseases (Russian Journal) ◽

10.18821/1560-9529-2018-23-3-126-133 ◽

2018 ◽

Vol 23 (3) ◽

pp. 126-133

Author(s):

Irina B. Zakharova

Keyword(s):

Southeast Asia ◽

Burkholderia Pseudomallei ◽

Fatal Outcome ◽

Severe Infection ◽

Northern Australia ◽

The Past ◽

The Pacific ◽

Imported Cases ◽

Infection Disease ◽

The Caribbean

Introduction. Melioidosis is a severe infection disease with the high mortality rate due to saprophytic bacterium Burkholderia pseudomallei. For the time present, the area of the distribution of the pathogen is much wider than in the case of the traditionally endemic Southeast Asia and Northern Australia and covers the humid tropics and subtropics of all continents. Methods. The search for data and analysis of disease cases in non-endemic areas for the period from 2003 to April 2017. Results. Over the past 15 years, 120 cases of melioidosis in non-endemic countries were described, that is 5,5 times higher than in the same previous period. There is no direct dependence of infection probability on the age and risk factors, but the presence of diabetes or chronic diseases doubles the risk of a fatal outcome of melioidosis. Southeast Asia still prevails as the origin of infection (62.5% of cases), however, the number of imported cases of melioidosis from Mexico, the Caribbean, South America, East Africa, Madagascar, China and the Pacific region begins to increase.

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A Fatal Case of Cerebral Melioidosis

Medical Journal of Shree Birendra Hospital ◽

10.3126/mjsbh.v18i2.22705 ◽

2019 ◽

Vol 18 (2) ◽

pp. 64-68

Author(s):

Raina Chaudhary ◽

Alina Singh ◽

Manoj Pradhan ◽

Reeba Karki ◽

Paawan Bahadur Bhandari

Keyword(s):

Infectious Disease ◽

Southeast Asia ◽

Otitis Media ◽

Burkholderia Pseudomallei ◽

Fatal Case ◽

Acute Otitis Media ◽

Northern Australia ◽

First Case

Introduction: Melioidosis is potentially fatal type of infectious disease caused by soil saprophytes Burkholderia pseudomallei. It is endemic to Southeast Asia and Northern Australia. We report the case of Cerebral Melioidosis which was consequences of acute otitis media. Patient was treated with Ceftazidime and Meropenem, despite of that patient died. To the best of our knowledge, this is the first case of cerebral melioidosis from Nepal.

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Burkholderia pseudomallei Penetrates the Brain via Destruction of the Olfactory and Trigeminal Nerves: Implications for the Pathogenesis of Neurological Melioidosis

mBio ◽

10.1128/mbio.00025-14 ◽

2014 ◽

Vol 5 (2) ◽

Cited By ~ 38

Author(s):

James A. St. John ◽

Jenny A. K. Ekberg ◽

Samantha J. Dando ◽

Adrian C. B. Meedeniya ◽

Rachel E. Horton ◽

...

Keyword(s):

Southeast Asia ◽

Nasal Cavity ◽

Burkholderia Pseudomallei ◽

Basal Layer ◽

The Body ◽

Northern Australia ◽

Cranial Cavity ◽

Content Type ◽

Trigeminal Nerves ◽

The Brain

ABSTRACT Melioidosis is a potentially fatal disease that is endemic to tropical northern Australia and Southeast Asia, with a mortality rate of 14 to 50%. The bacterium Burkholderia pseudomallei is the causative agent which infects numerous parts of the human body, including the brain, which results in the neurological manifestation of melioidosis. The olfactory nerve constitutes a direct conduit from the nasal cavity into the brain, and we have previously reported that B. pseudomallei can colonize this nerve in mice. We have now investigated in detail the mechanism by which the bacteria penetrate the olfactory and trigeminal nerves within the nasal cavity and infect the brain. We found that the olfactory epithelium responded to intranasal B. pseudomallei infection by widespread crenellation followed by disintegration of the neuronal layer to expose the underlying basal layer, which the bacteria then colonized. With the loss of the neuronal cell bodies, olfactory axons also degenerated, and the bacteria then migrated through the now-open conduit of the olfactory nerves. Using immunohistochemistry, we demonstrated that B. pseudomallei migrated through the cribriform plate via the olfactory nerves to enter the outer layer of the olfactory bulb in the brain within 24 h. We also found that the bacteria colonized the thin respiratory epithelium in the nasal cavity and then rapidly migrated along the underlying trigeminal nerve to penetrate the cranial cavity. These results demonstrate that B. pseudomallei invasion of the nerves of the nasal cavity leads to direct infection of the brain and bypasses the blood-brain barrier. IMPORTANCE Melioidosis is a potentially fatal tropical disease that is endemic to northern Australia and Southeast Asia. It is caused by the bacterium Burkholderia pseudomallei, which can infect many organs of the body, including the brain, and results in neurological symptoms. The pathway by which the bacteria can penetrate the brain is unknown, and we have investigated the ability of the bacteria to migrate along nerves that innervate the nasal cavity and enter the frontal region of the brain by using a mouse model of infection. By generating a mutant strain of B. pseudomallei which is unable to survive in the blood, we show that the bacteria rapidly penetrate the cranial cavity using the olfactory (smell) nerve and the trigeminal (sensory) nerve that line the nasal cavity.

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First Genome Sequence of a Burkholderia pseudomallei Isolate in China, Strain BPC006, Obtained from a Melioidosis Patient in Hainan

Journal of Bacteriology ◽

10.1128/jb.01577-12 ◽

2012 ◽

Vol 194 (23) ◽

pp. 6604-6605 ◽

Cited By ~ 12

Author(s):

Yao Fang ◽

Yong Huang ◽

Qian Li ◽

Hai Chen ◽

Zhen Yao ◽

...

Keyword(s):

Antibiotic Therapy ◽

Southeast Asia ◽

Genome Sequence ◽

High Mortality ◽

Burkholderia Pseudomallei ◽

Northern Australia ◽

Content Type ◽

Relapse Rates

ABSTRACTMelioidosis, caused byBurkholderia pseudomallei, is considered to be endemic to Northern Australia and Southeast Asia, with high mortality and relapse rates, regardless of powerful antibiotic therapy. Here we report the first genome sequence ofBurkholderia pseudomalleistrain BPC006, obtained from a melioidosis patient in Hainan, China. The genome sizes of the 2 chromosomes were determined to be 4,001,777 bp and 3,153,284 bp.

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ACTUAL ISSUES OF MODERN EPIDEMIOLOGY OF MELIOIDOSIS: A LITERATURE REVIEW AND ANALYSIS OF IMPORTED CASES TO NON-ENDEMIC REGIONS

Epidemiology and Infectious Diseases (Russian Journal) ◽

10.18821/1560-9529-2019-23-3-126-133 ◽

2018 ◽

Vol 23 (3) ◽

pp. 126-133

Author(s):

Irina B. Zakharova

Keyword(s):

Southeast Asia ◽

Burkholderia Pseudomallei ◽

Fatal Outcome ◽

Severe Infection ◽

Northern Australia ◽

The Past ◽

The Pacific ◽

Imported Cases ◽

Infection Disease ◽

The Caribbean

Introduction. Melioidosis is a severe infection disease with the high mortality rate due to saprophytic bacterium Burkholderia pseudomallei. For the time present, the area of the distribution of the pathogen is much wider than in the case of the traditionally endemic Southeast Asia and Northern Australia and covers the humid tropics and subtropics of all continents. Methods. The search for data and analysis of disease cases in non-endemic areas for the period from 2003 to April 2017. Results. Over the past 15 years, 120 cases of melioidosis in non-endemic countries were described, that is 5,5 times higher than in the same previous period. There is no direct dependence of infection probability on the age and risk factors, but the presence of diabetes or chronic diseases doubles the risk of a fatal outcome of melioidosis. Southeast Asia still prevails as the origin of infection (62.5% of cases), however, the number of imported cases of melioidosis from Mexico, the Caribbean, South America, East Africa, Madagascar, China and the Pacific region begins to increase.

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Disseminated septicaemic melioidosis: an unusual presentation of masticator space infection

The Journal of Laryngology & Otology ◽

10.1258/002221503321626528 ◽

2003 ◽

Vol 117 (5) ◽

pp. 417-418 ◽

Cited By ~ 2

Author(s):

Somchai Srirompotong ◽

Wisoot Reechaipichitkul

Keyword(s):

Infectious Disease ◽

Southeast Asia ◽

Burkholderia Pseudomallei ◽

Bacterial Infections ◽

Unusual Presentation ◽

Diabetic Patients ◽

Northern Australia ◽

Masticator Space ◽

Space Infection ◽

Deep Neck Infections

Melioidosis is an infectious disease caused by a saprophytic bacterium, Burkholderia pseudomallei. It is endemic to Southeast Asia and Northern Australia. The spectrum of melioidosis in humans varies from sub-clinical to overwhelming protean manifestations resembling other acute and chronic bacterial infections. Disseminated septicaemia melioidosis presenting as a masticator space infection is reported here. This is germane to those treating diabetic patients with deep neck infections living in, or having visited, areas endemic for B. pseudomallei.

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